ABSTRACT
Health data interoperability is essential for enabling seamless communication, data sharing, and coordinated care across diverse healthcare systems. As digital transformation accelerates within the health sector, the adoption of standardized data exchange protocols becomes increasingly critical. This paper presents a critical review of prominent health data interoperability standards, focusing on Fast Healthcare Interoperability Resources (FHIR), Health Level Seven (HL7), and other emerging frameworks. The review evaluates the historical evolution, structural design, implementation mechanisms, and comparative strengths and limitations of these standards in real-world clinical environments. FHIR, developed by HL7, represents a modern, web-based approach to healthcare data exchange, emphasizing modular resources, RESTful APIs, and flexibility for mobile and cloud-based applications. In contrast, earlier HL7 versions such as v2 and v3 utilize more rigid, message-based architectures. Although HL7 v2 remains widely used, it faces challenges in scalability and semantic consistency. The paper also explores other interoperability frameworks, including Digital Imaging and Communications in Medicine (DICOM) for imaging data, Integrating the Healthcare Enterprise (IHE), and openEHR. Special attention is given to the role of semantic interoperability, data governance, and compliance with privacy regulations such as HIPAA and GDPR. Findings highlight that while FHIR has significantly advanced interoperability by offering extensibility, developer support, and better alignment with modern software paradigms, challenges remain in universal adoption, data standardization across vendors, and integration with legacy systems. The review further identifies gaps in cross-border data sharing, patient consent management, and data provenance. Recommendations are made for harmonizing standards, promoting open APIs, and fostering collaboration among stakeholders including vendors, regulators, and clinicians. This critical synthesis provides healthcare organizations, policymakers, and developers with a comprehensive understanding of the current landscape and future directions of health data interoperability. By aligning technical standards with clinical needs and regulatory frameworks, the industry can move toward more connected, patient-centered care systems.
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